Provider Demographics
NPI:1285653782
Name:SCHEFFEL, JOHN ANDREW (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ANDREW
Last Name:SCHEFFEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 VERNON ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01610-1988
Mailing Address - Country:US
Mailing Address - Phone:508-755-2466
Mailing Address - Fax:508-755-6883
Practice Address - Street 1:95 VERNON ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-1988
Practice Address - Country:US
Practice Address - Phone:508-755-2466
Practice Address - Fax:508-755-6883
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2171213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0324183Medicaid
MAU85981Medicare UPIN
MAY75099Medicare ID - Type Unspecified